Healthcare Provider Details

I. General information

NPI: 1487373510
Provider Name (Legal Business Name): MVP ALLIANCE, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 N TARRANT PKWY STE 400
FT WORTH TX
76177-8631
US

IV. Provider business mailing address

550 BAILEY AVE STE 750
FT WORTH TX
76107-2175
US

V. Phone/Fax

Practice location:
  • Phone: 817-591-4624
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: APRIL SAWYER
Title or Position: SR DIR OF REV CYCLE MGMT
Credential:
Phone: 817-202-5179